Rethinking ‘cultural competence’ in international social work

Cultural competence and international social work

Cultural competence is a prominent concept in international social work. It has emerged within what can be termed as multicultural social work discourse. Due to the enormous global and demographic changes of the past half-century, Western societies have become much more diverse and complex than ever before. These changes have dramatically influenced the helping professions in general and social work in particular. As a consequence, we’ve seen a shift in social work from reliance on the ‘melting-pot’ and assimilation models of the 1960s towards the models of multiculturalism developed in the 1980s.

Attempts to incorporate multicultural ideology into social work have given rise to professional terminologies with a practical flavour. A variety of terms have emerged to describe the competencies required from professionals and agencies working in cross-cultural situations. Among them are ethnic sensitivity (Devore and Schlesinger, 1987), cultural awareness (Green, 1999), (inter-)cultural sensitivity (Al-Krenawi and Graham, 2000; Sachdev, 1997) and cultural competence (Cross et al., 1989; Lum, 2005, 2011; NASW, 2001, 2007; Sue, 1998). These are used – not only in social work – as key concepts for implementing multicultural ideology in professional practice. For the past decade, the most prevalent of these terms, at least in the English-speaking world, has been cultural competence (Garran and Werkmeister-Rozas, 2013).

Cultural competence has received many definitions (Boyle and Springer, 2001). According to the American National Association of Social Workers (NASW), it refers to the process by which individuals and systems respond respectfully and effectively to people of all cultures, languages, classes, races, ethnic backgrounds, religions and other diversity factors, in a manner that recognizes, affirms and values the worth of individuals, families and communities, and protects and preserves the dignity of each (NASW, 2001).

Another prevalent definition is that ‘Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enable the system, agency, or those professionals to work effectively in cross-cultural situations’ (Cross et al., 1989: iv). When translated into practice, various social work authors have tended to focus on particular intervention skills with specific populations (Boyle and Springer, 2001; Lum, 2005, 2011; NASW, 2001, 2007; Sue, 1998).

Within multicultural social work discourse, cultural competence is usually conceptualized and argued within a specific local context, most often a nation-state. It therefore deals with domestic diversity and its implications for social work at micro-, meso- and macro-levels (Lum, 2011). Moreover, the local public discourse on multiculturalism, and the area’s ethnic and social demographic composition, will shape the specific meanings ascribed to cultural competence. For example, the standards for cultural competence in social work practice used by the NASW (2001) begin by discussing the ever-growing diversity within the United States and the challenges this presents to social workers in their daily work. In Israel, the Jewish/Arab divide within the ongoing political conflict and its implications have been found to be a major issue when addressing multicultural social work practice (Nadan and Ben-Ari, 2013).

International social work, however, is dedicated to comparing social development, problems, welfare systems and policy, as well as practice models and methods between different countries (Nuttman-Shwartz and Berger, 2012). Cultural competence in international social work would therefore focus primarily on working with differences across national borders. Cultural differences inevitably exist. However, due to the defining character of international social work practice as a profession that crosses boundaries (Nuttman-Shwartz and Ranz, 2013), the main prism, or the leading category of difference, would be nationality. The primary focus on nationality, however, reduces the complexity offered by the NASW (2001) definition, which acknowledges differences across and within groups by including a broad set of categories such as culture, language, class, race, religion and other diversity factors.

Cultural competence is seen as ‘essential to all aspects of international social work’ (Healy, 2008: 361). This idea, that professionals should be culturally competent when operating in international settings, is widely consensual and has received vast scholarly attention, especially in discussions about international social work education and specifically international field placement. Here, cultural competence serves as a key argument when advocating the importance and necessity of implementing international content in social work education and developing educational programmes abroad. Such programmes are perceived as necessary for preparing students (and faculty) to work competently in diverse environments – both domestically and abroad (Blunt, 2007; Boyle et al., 1999; Fairchild et al., 2006; Gilin and Young, 2009; Nuttman-Shwartz and Berger, 2012; Razack, 2002; VeLure-Roholt and Fisher, 2013). Field placement in another country offers students the opportunity to experience professional practice with culturally diverse clients, which sometimes cannot be produced within the borders of their home country. It might help students to learn about interactions that promote understanding between cultures and thus improve their capacity for effective work both at home and abroad (Mathiesen and Lager, 2007).

And indeed, there is solid and consistent evidence that international field placement is an effective means of developing and increasing cultural competence among students and faculty (Abram et al., 2005; Boyle et al., 1999; Corbin, 2012; Greenfield et al., 2012; Lindsey, 2005; Mathiesen and Lager, 2007; Moorhead et al., 2013; Rotabi et al., 2006). This is true for various lengths of stay – as short as 10 days (Fairchild et al., 2006; Gilin and Young, 2009), three weeks (Nuttman-Shwartz and Ranz, 2013), one month (Anderson et al., 2006), or up to a year (Pedersen, 2010).

The contribution of international field placement to developing cultural competence was shown in various quantitative studies using instruments such as the Cultural Competence Scale (Krajewski-Jaime et al., 1996) and the Multicultural Counselling Awareness Scale (MCAS), and utilizing pre- and post-participation in a study-abroad program (Boyle et al., 1999) to indicate the increase in cultural competence among participants and faculty. Qualitative designs and case studies have demonstrated that international field placement contributed to appreciation of differences and development of cultural competence skills (Boateng and Thompson, 2013; Lindsey, 2005). This was also the case in mixed method designs. For example, the results from the Multicultural/Awareness/Knowledge/Skills Survey (MAKSS) and pre- and post-focus groups indicate that participants in an intensive short-term programme reported overwhelmingly positive changes in their attitudes, perceptions and knowledge of aspects of multiculturalism, as was also measured on the MAKSS instrument (Fairchild et al., 2006). In sum, research findings strongly indicate the contribution of international field placement to enhancing cultural competence, and further strengthen the argument for implementing study-abroad programmes.

From this review of the literature it appears that such programmes focus predominantly on providing knowledge about cultures, cultivating awareness of and sensitivity to cultural differences, and developing skills to work in cross-cultural situations. It seems, however, that these programmes tend to avoid the more critical (Sisneros et al., 2008), anti-oppressive and anti-racist (Dominelli, 1998) approaches to cultural competence. Such perspectives would invite a shift in attention from the ‘other’ to the ‘self’, as well as exploring global power relations and white privileges (Jeyasingham, 2012; Kondrat, 1999). Frankenberg (1993) refers to ‘whiteness’ as a location of structural advantage of race privilege; as a ‘standpoint’ from which white people look at themselves, at others and at society; and as a set of cultural practices that are usually unmarked and unnamed. These critical perspectives are generally not given priority in the majority of pedagogical progammes in international social work.

Two theoretical perspectives on cultural competence

To broaden and problematize our discussion about cultural competence in international social work, I will now discuss how two theoretical perspectives widely used in social work – essentialism and constructivism – view the concept of cultural competence. In short, essentialism views phenomena as having an objective indwelling essence, a sort of ‘true nature’. Hence, a category is viewed as a natural entity, possessing a specific essence that sets it apart from other categories. This essence automatically and unambiguously places the phenomena into specific determined and unchanging categories. The main task of science is to observe and discover the true nature of things, that is, their essential qualities (Lincoln and Guba, 1985). Constructivism, however, views phenomena as subjective and socially constructed. These constructs are dynamic and can be meaningful only within a specific context (society, culture, history, language, etc.) (Gergen, 1985). Therefore, categories/constructs are a matter of definition and construction, and cannot be understood as existing outside human consciousness (Ben-Ari, 2001).

The construct of ‘Cultural Competence’ can be understood from these two theoretical perspectives. Essentialism would view cultural competence from the traditional standpoint of culture and ethnicity as pre-determined, static and homogenous. Thus, if a specific cultural group is perceived as an entity whose members share some essential defining characteristics, it is possible for professionals to develop schema allowing them to interact ‘more competently’ with its group members. From this point of view, cultural competence can be acquired in a developmental and cumulative learning process.

Constructivism, however, views identities as socially constructed and therefore as embedded within a context, as well as continually changing and evolving under internal and external circumstances (Burr, 1995; Rosenblum and Travis, 2011). Therefore, there is no reason to expect the individual, who is influenced by a unique combination of personal and collective narratives, ideologies and other factors, to be identified with a fixed set of coherent values, beliefs or experiences that can be summarized as a cultural profile. Cultural competence thus depends more on the skills of professionals in exploring the diverse identities of the people they are working with. These identities are derived from the intersections between various categories of difference, including gender, social class, religion, spirituality, age, (dis)ability, sexual orientation, marital and residential status, etc. (Davis, 2008). Here, the social worker is asked to operate from a position of not-knowing (Dyche and Zayas, 1995), or even as an ethnographer (Thornton and Garrett, 1995) who explores the uniqueness of people within a specific context.

It can be argued that essentialist perspectives have strongly influenced the traditional thinking about cultural competence in social work (Wehbi, 2009; Wong et al., 2003). This can be understood from the way the term is used in the theoretical and practical literature, where it combines three major elements (Green, 1999; Lum, 2011; NASW, 2001; Sue, 2006). First, awareness: this mainly refers to the practitioner’s self-awareness of his or her own cultural values, beliefs, attitudes, prejudices, and his /her emotional and cognitive processing of cross-cultural encounters. Second, knowledge: the knowledge required for cultural competence usually concerns a specific cultural or ethnic group, most often the one with whom the practitioner is working. This includes knowledge of that group’s history, norms, traditional cultural characteristics, values, gestures, communication styles, behaviours, attitudes, help-seeking patterns and the group’s explanatory models of their problems. Third, skills: the skills inherent in cultural competence arise from the ability to combine awareness and knowledge in professional practice and to perform interventions that are congruent with the client’s culture. The professional literature is full of articles and book chapters dealing with the knowledge and skills required for culturally competent practice with specific groups – often those who are marked as ‘other’ in society.

Operationally defined, cultural competence is the integration and adaptation of knowledge about individuals and groups into specific standards, policies, practices and attitudes (Pope-Davis and Coleman, 1997). To work effectively with diversity, practitioners are expected to know about different cultural practices and world-views, to develop awareness of their own cultural world-view, to have a positive attitude towards cultural differences and to develop cross-cultural skills. Here we see the strong linear relationship between knowledge of the ‘other’ and effective working with differences (Ben-Ari and Strier, 2010).

Challenges for cultural competence in international social work

It can be argued that the common essentialist conceptualization of cultural competence is risky, especially in the context of international social work, for three main reasons. First, essentialist conceptualizations lead to a focus on acquiring knowledge about the ‘other’ – knowledge that is mostly derived from cultural descriptions of ethnic or national groups. This can lead to over-generalization and stereotypical attitudes toward people who belong to such a broad grouping (Stuart, 2004), imposing stereotypes of observed characteristics on individuals who identify with that grouping. At the same time, the tendency to focus on cultural customs of specific cultural or national groups can lead to a more folkloric view, marking the culture of the ‘other’ as ‘special’, different and/or exotic. Focusing on acquiring knowledge about the ‘other’ can create the false impression that the question ‘who is’ or ‘what is’ the ‘other’ can be answered. This notion may lead to the view that culture can be understood as a simple combination of elements that are mistakenly seen to characterize an entire country: language, dress, music, food, religious customs and family structures, etc. (Wehbi, 2008). As such, the ‘other’ may be perceived as a uniform, knowable object (Ben-Ari and Strier, 2010). This view of the ‘other’ is especially problematic when considering Emanuel Levinas’s (1947) argument that knowing the ‘other’ does not enable a person to fulfil their ethical commitment towards him or her, because the ethic of responsibility takes precedence over any search for truth or knowledge (Beals, 2007). Levinas argues that otherness is radical in the sense that the ‘other’ cannot become an object of the self, but always stays beyond the attempts of the self to fully understand and know it. So the ‘other’ is an entity that cannot be known, and its otherness is infinite (Levinas, 1947).

The second reason why focusing on knowledge of the ‘other’ – its history, cultural characteristics, etc. – is risky is that it might lead to neglecting ourselves. My own research (Nadan, 2012) shows that in social work discourse in Israel, social work educators tend to construct ‘others’ as ‘having culture’ – that is, as having particular and distinct cultural characteristics – while ‘we’, the social workers, who mostly belong to the dominant group in society, tend to construct ourselves as opposed to the ‘other’ and therefore as having no culture (being ‘culture-free’ or ‘cultureless’ (Perry, 2001)). Along this line, Wehbi (2009) mentions that when students (from dominant groups) are asked to describe their own cultures they are often at a loss because their own culture may never have held any interest for them. Concentrating on the ‘other’ while neglecting ourselves ignores interdependency and the power relations embedded in the relationships within countries, and specifically paves the way for avoiding inquiring into the existing power relations between North and South.

Third, adopting a postcolonial perspective raises the question of how an essentialist position, focusing at the same time on knowledge about the ‘other’ as well as neglecting ourselves, can serve as a means of producing the otherness of the ‘other’ (or making the other, ‘other’). Edward Said’s argument, presented in his influential book Orientalism (Said, 1978), states that transmitting knowledge about the ‘other’ within a context of power relations does not merely describe and portray the ‘other’, but carries a strong subtext. It is also a way of constructing and producing the ‘other’, who can only be viewed as subordinate to the ‘self’ (Park, 2005). According to Said, knowledge about the ‘other’ can easily be translated into a Western form of control.

The essentialist view of cultural competence is therefore problematic when working with differences, especially in an international context, where the relationship between ‘us’ and ‘them’ can be embedded within clear historical as well as present-day power differentials. This is even intensified due to the fascination with other cultures that is one of the students’ motivations for undertaking international placement. Wehbi (2009) finds this interest disconcerting, because of its potential to be fuelled by and to perpetuate cultural imperialism and voyeurism within the broader framework of students from Northern contexts going to the South (Razack, 2002).

Reflective cultural competence

Adopting a more constructivist approach to cultural competence leads us to consider two aspects that are missing in the prevalent traditional essentialist approach. The first is contextuality and the second is power relations. I suggest that reflecting on these two constructs and bringing them to the fore in our discussions with students and among ourselves is crucial for social work practice, especially in an international context.

Contextuality refers to the diverse and changing realities of the local and global cultural, social and political environments, and to the ways in which context shapes people’s experiences and the meanings given to them. Context is not a new concept to social work, and there seems to be a consensus that ‘good’ social work is inevitably contextual (Lyngstad, 2012). Recently, the term ‘context-informed’ was suggested (Roer-Strier and Sands, 2014) to describe an approach that takes into account the effects of history, politics, hegemonic power relations, oppression, globalization, and other conditions. However, within the reflective view of cultural competence, I wish to highlight how context not only shapes the realities and lives of clients, but how it shapes practitioners’ and educators’ way of thinking, ascribed meanings, and images of the ‘other’. This can (and should) be done in the framework of international social work education.

For example, in an international inter-group encounter between German and Israeli social work students in which I was professionally involved (Nadan, Weinberg-Kurnik and Ben-Ari, 2013), participants began to realize how context shaped the way in which they perceived the ‘other’, and that otherness is constructed through interpersonal and collective processes. Students reported that during the group discussions and through the reflection assignments, they started to understand that in some contexts the ‘other’ can be seen as ‘similar’, while in other contexts it could be seen as ‘other’. Moreover, the students found that particular geographical or academic contexts stimulated the emergence of specific categories of difference, such as nationality or ethnicity, while in alternative contexts other categories such as gender or social class were dominant. It became clear that each context brings to the fore other categories of difference, and these become meaningful parameters for them to view and construct the ‘other’ and at the same time to present and experience themselves. A more complex view of cultural competence has therefore emerged, moving beyond nationality to perceiving other categories of difference, and acknowledging distinctions both between and within each of the groups. During the group work, a critical reflection on the crucial role of context helped students to examine the importance of context in constructing the ‘self’, the ‘other’ and the relationship between them. Bringing the context to the fore therefore facilitates the shift from focusing on the ‘other’ to inquiring also about our own role and social positioning in relation to the context and to the ‘other’.

When we begin to look at the relationship between different actors, power relations become significant. Power relations refers to a critical reflectivity on power differentials and their consequences both for the less powerful group (e.g. their experiences of marginality, oppression, being silenced) and for the more powerful group (including privileges such as access to resources, dominance, and the silencing of other groups). Critical reflection on power relations enables participants to ask which point of view counts, whose voice is being heard, and whose professional knowledge is considered ‘reliable’ and ‘advanced’. More than that, those ‘local’ questions might shed light on bigger, sometimes parallel power relations encompassing these interpersonal or inter-group interactions, and lead to inquiry into the global dynamics shaping these processes (such as the minority–majority relationship, North–South, etc). For example, in conflict-ridden areas, power relations reflect on the ‘weight’ given to each side’s collective narrative and to the realization that the narrative of the more powerful group is perceived as representing historical fact and truth, while that of the less powerful group is perceived as being of doubtful reliability.

Reflecting on power relations enables an inquiry into the ways in which context shapes power differentials, and gives an insight into how power relations operate in actual practice (e.g. in group work), where they may represent a wider macro-structural and societal context. For these reasons, I would strongly encourage educators to incorporate pedagogical practices that lead practitioners to reflect critically on the (mostly invisible) ‘whiteness’ within the international context, through shifting attention from ‘them’ towards ‘us’, from the ‘other’ to the ‘self’ (Jeyasingham, 2012; Young and Zubrzycki, 2011). Acknowledging white superiority and privilege is crucial in our profession, since white people tend to interpret their social world through common, sometimes unconscious, racist frameworks. Critically reflecting on race, racism and ‘whiteness’ requires a particular kind of vigilance, breadth of vision, and refusal of ‘either-or’ thinking (Frankenberg, 2001). International social work offers a remarkably suitable framework for that. Such reflectivity emphasizes the inseparable relationship between micro- and macro-levels, as well as the interconnectedness of privilege and oppression. It allows us to recognize that power differentials inevitably influence ‘self’ and ‘other’ relationships.

Context and power relations are two major pillars in critical and anti-oppressive social work, which highlights a striving for social justice and equality and argues that these can be achieved only when dealing with fundamental questions relating to the wider socio-political context and its embedded power relations (Gorski, 2009; Jenks et al., 2001; Sisneros et al., 2008). Taking this further, critical social work education is interested in examining expressions of power differentials that are reconstructed within social agencies and in the professional relationships between social workers and their clients (Dominelli, 2004). The advocates of this approach are especially interested in examining how practitioners’ social positions, which are largely privileged, shape their professional relationships, including their attitudes towards and images of the ‘other’ (Abrams and Gibson, 2007; Jeyasingham, 2012; Kondrat, 1999; Nylund, 2006; Sisneros et al., 2008). International social work holds the potential to further develop students’, professionals’ and educators’ reflective cultural competence – where reflectivity on context and power relations is at the centre of their professional practice.

Conclusion

In order to become more ethical and anti-oppressive, social work in international settings should adopt a more constructive and reflective view of cultural competence. This may be achieved by shifting the focus more to the political dimension of international social work practice and education – to issues of power relations, oppression and inequality – and by employing a critical, anti-racist and postcolonial perspective. As social work educators operating in international settings, we should encourage the development of critical reflectivity among ourselves and among our students in relation to their own social positions and to the ways in which these shape their assumptions, attitudes and images relating to the ‘other’. In so doing, we can contribute to the professional efforts to educate critical, reflective and socially committed practitioners, and can help them to meet the challenges of international social work in a contemporary world characterized by growing diversity, intergroup tensions, and ethnic and political conflicts.